Laparoscopic Gastric Wedge Resection
Tags: General Surgery
Table of Contents
Port placement (Umbilical port)
- Incise skin and dissect down to fascia.
- Place fascial stay sutures and open fascia and peritoneum.
- Sweep any abdominal structures away from port site with finger sweep.
- Place umbilical port.
- Other two ports placed under direct vision of camera passed through abdominal port.
Inspection of abdominal contents
- Identify any peritoneal adhesions.
Placement of lateral ports
- Under direct vision via umbilical port
Identification of stomach and greater omentum
Mobilization of greater omentum and entry into lesser sac
- Ligasure used to divide short gastric vessels close to edge of greater curvature of the stomach.
Identification of mass
- Mass tattooed preoperatively by gastroenterology service.
Excision of mass
- Endo-GIA stapler with 45mm load used to staple across base of mass.
Lysis of adhesions
- Removal of specimen via endo-catch bag
- Inspection of abdominal contents and gastric staple line
- Fascial closure
- Infiltration of local anesthetic